Provider Demographics
NPI:1881764751
Name:CLINICAL SYSTEMS, INC.
Entity type:Organization
Organization Name:CLINICAL SYSTEMS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:G
Authorized Official - Last Name:HOWIE
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:217-529-2142
Mailing Address - Street 1:3151 BUTLER ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62703-4300
Mailing Address - Country:US
Mailing Address - Phone:217-529-2142
Mailing Address - Fax:217-529-2174
Practice Address - Street 1:3151 BUTLER ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62703-4300
Practice Address - Country:US
Practice Address - Phone:217-529-2142
Practice Address - Fax:217-529-2174
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X, 101YP2500X, 101YP2500X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0008415010OtherBLUECROSS BLUESHIELD